With the cough, cold, flu, and coronavirus season upon us, it is important to understand the ingredients in over-the-counter cough and cold medicine.  The product names can be so deceiving and confusing, and all too often my patients will pick up the wrong box thinking that all cough and cold syrups are the same.   They are not!  Flip that box around and look at the main ingredients.   Let me break it down for you:

Guaifenesin:  This is a mucolytic; it helps to thin and break up the mucous so that it can be more easily expectorated (coughed up).  Guaifenesin can be found in its generic form or in the brand names Mucinex or Robitussin. 

Dextromethorphan:  This is the “DM” that you will see on the labels (i.e. Robitussin DM or Mucinex DM).  It is a cough suppressant.  It should be used with caution in patients with chronic bronchitis or COPD.   

Phenylephrine and Pseudoephedrine:  These are decongestants that are often added to cough syrups and then advertised for “cough and cold” (i.e. Robitussin Cough and Cold).  They help with that nagging sinus congestion and runny nose by drying up the mucous.  These ingredients should be avoided in patients with high blood pressure.  If a cough syrup is labeled “safe for high blood pressure,” then it does not contain these ingredients. 

Chlorpheniramine:  This is an antihistamine that also helps with congestion and drying of the respiratory passageway.  It is less sedating than the well-known antihistamine, Benadryl, but should still be used with caution in the elderly.  And it is not recommended if driving/piloting/operating machinery, etc. 

In my older patients, I will often tell them to get plain guaifenesin to take during the day and guaifenesin DM to take at night to suppress the cough while they are sleeping.  Rarely do I let my older patients take anything other than these two ingredients.  So, just because something is over-the-counter, does not mean that it is safe for everyone.  If you are in need of a cough or cold medication, please check with your provider or pharmacist to make sure you are buying the right one.  And if this is for a child, ALWAYS check with your pediatrician first. 

From my home to yours,

Dr. Christine Pluta
Medical Director
www.smahousecalls.com